Pharmacotherapy for smoking cessation

Several high-quality meta-analyses have investigated pharmaceutical interventions for smoking cessation, and guidelines have been published by several organisations. First-line pharmacological drugs for smoking cessation are nicotine replacement products (patch, gum, inhaler, nasal spray, lozenge/tablets, and oral spray), varenicline and bupropion, with scientifically well-documented efficacy when used for 2–3 months, mostly mild side-effects and at least a doubling of the 1-year quit rate compared with placebo (table 2). However, a 100% cure rate is not achievable and a typical finding in most studies of smoking cessation is a 1-year quit rate of about 25–35%, similar to the quit rates in other dependencies such as alchohol and opiates. To stop smoking is to break a complex habit and addiction and, to achieve reasonable quit rates, it is necessary to provide psychological support combined with pharmacological drugs.